非细菌性血栓性心内膜炎（NBTE）是一种特殊的疾病，其特点是由于高凝状态和心内膜损伤导致心脏瓣膜上出现无菌纤维蛋白沉积。目前很少有大型队列研究能够阐明与该病发病率和死亡率相关的因素。本研究通过使用PubMed、Embase、Cochrane和Web-of-Science数据库，检索截至2022年9月的NBTE病例报告和系列，进行了系统文献综述。首先进行基本特征的描述性分析，随后进行多元回归分析以确定与发病率和死亡率相关的风险因素。共鉴定了416份病例报告和系列，其中提取了450名患者。女性与男性的比例约为2:1，总体样本的中位年龄为48岁（四分位数范围[IQR]：34-61）。类似中风的症状是最常见的表现，70%的病例出现栓塞性现象，其中大部分是由于中风。与其他NBTE病因相比，肿瘤与更高的栓塞性并发症相关（校正后的OR值为6.38，95%CI=3.75-10.83，p<0.01），而年龄、性别和瓣膜软组织块大小则不相关（p>0.05）。全因住院死亡率为36%，其中肿瘤病因与更高的死亡率相关：56%（校正后的OR值为3.64，95%CI=1.57-8.43，p<0.01），而其他NBTE病因的死亡率为19%。与20世纪入院患者相比，近年来NBTE的死亡率显著下降（校正后的OR值为0.07，95%CI=0.04-0.15，p<0.01）。尽管近年来NBTE入院患者的住院死亡率整体上有所改善，但需要注意的是与肿瘤病因相关的病例在住院期间仍与较高的发病率和死亡率相关。版权所有©2023 Elsevier Ltd. 保留所有权利。

Non-bacterial thrombotic endocarditis (NBTE) is a distinctive condition marked by the presence of aseptic fibrin depositions on cardiac valves due to hypercoagulability and endocardial damage. There is a scarcity of large cohort studies clarifying factors associated with morbidity and mortality of this condition.A systematic literature review was performed utilizing the PubMed, Embase, Cochrane, and Web-of-Science databases to retrieve case reports and series documenting cases of NBTE from inception until September-2022. A descriptive analysis of basic characteristics was carried out, followed by multivariate regression analysis to identify risk factors associated with morbidity and mortality.416 case reports and series were identified, of which 450 patients were extracted. The female-to-male ratio was around 2:1 with an overall sample median age of 48(interquartile range [IQR]:34-61). Stroke-like symptoms were the most common presentation and embolic phenomena occurred in 70% of cases, the majority of which was due to stroke. Cancer was associated with higher embolic complications (aOR:6.38,95%CI=3.75-10.83,p<0.01) in comparison to other NBTE etiologies, while age, sex, and vegetation size were not (p>0.05). All-cause in-hospital mortality was 36%, with cancer etiology being associated with higher mortality: 56%(aOR:3.64,95%CI=1.57-8.43,p<0.01) in comparison to other NBTE etiologies:19%. A significant decrease in NBTE mortality was seen in recent years in comparison to admissions that occurred during the 20th-century (aOR:0.07,95%CI=0.04-0.15,p<0.01).While there has been an observed improvement in overall in-hospital mortality rates for patients admitted with NBTE in recent years, it is important to note that cases associated with a cancer etiology are still linked to high morbidity and mortality during hospitalization.Copyright © 2023 Elsevier Ltd. All rights reserved.